Identification of Risk Factors for Renal Insufficiency in Primary Membranous Nephropathy

To identify possible evidence linking certain characteristics associated with primary membranous nephropathy (PMN) to renal failure progression in patients diagnosed with PMN and to establish probable evidence of an association between PMN and other risk factors leading to end-stage renal failure.

A historical investigation was carried out including 436 subjects with PMN, with or without renal insufficiency, who were treated at the No. 82 Division Defense Medical Center of the People's Liberation Army and Liaocheng People's Medical Center during January 2020 and December 2023. Binary logistic regression study was applied to determine possible hazard elements. Binary logistic regression analysis was employed to identify potential risk factors, while the diagnostic capabilities of statistically significant continuous variables were assessed through detector performance feature receiver operating characteristic (ROC) plots.

Dichotomous logit regression study detected age, blood uric acid level, 24-hour urinary protein level, crescent formation, and renal tubular atrophy/interstitial fibrosis as independent risk factors for renal insufficiency, while hemoglobin level was a protective factor. The ROC analysis showed that age, 24-hour urine protein, and uric acid level had areas under the curve of 0.711 (p < 0.05), 0.652 (p < 0.05), and 0.60 (p < 0.05), with optimal threshold values of 52.5 years, 4.815 g/24 hour, and 446.5 μmol/L.

Advanced age, hyperuricemia, anemia, high proteinuria, crescent formation, and renal tubular atrophy/interstitial fibrosis are significant risk factors for renal insufficiency in PMN patients. These findings may help to facilitate risk categorization and referral patterns.